The Outcomes of Cemented Femoral Revisions for Periprosthetic Femoral Fractures in the Elderly: Comparison with Cementless Stems

Figures & data

Table 1 Demographics of Patients

	Study Group	Control Group
Number of patients	21	16
Number of hips	21	16
Age (mean; range; years)	79 (63–89)	63 (35–77)
Gender
Female	14	7
Male	7	9
Right side	14	9
Left side	7	7
ASA score, average	2.81	2.25
ASA-1	-	1
ASA-2	6	11
ASA-3	13	3
ASA-4	2	1
Charlson comorbidity index, average	4.76	2.31
Time from admission to surgery (mean; range; days)	5.2 (1–13)	4.9 (2–8)

Figure 1 The study flow-chart.

Table 2 Clinical Results of Patients

	Study Group^+	Control Group^++
Follow-up (mean; range; months)	55 (0–99)	62 (7–124)
Preoper.pain score± the postoper.increase at 12 months postoperatively (mean; points)	1+4.8	1+4.7
Hip flexion at 12 months postoperatively (mean; range; degrees)	86 (60–120)	88 (70–100)
Hip abduction at 12 months postoperatively (mean; range; degrees)	29 (15–40)	29 (15–40)
Preoper.Merle d’Aubigné and Postel score ± the postoper.increase at 12 months postoperatively (mean; points)	2+10.7	2+12.5
Functional status preoperatively
Independent ability to walk	20	16
Support from another person or use of wheelchair	1	-
Functional status at the time of latest follow-up
Independent ability to walk	14	16
Support from another person or use of wheelchair	7	-

Notes: ⁺Two patients lost to further follow-up within the first month after surgery. ⁺⁺One patient lost to further follow-up 7 months after surgery.

Figure 2 Preoperative anteroposterior radiograph of a Vancouver type B1 periprosthetic femoral fracture in a 77-year-old female (A) treated with a long cemented femoral stem (B). At 5 years of follow-up, the fracture was healed and the stem did not show any sign of aseptic loosening.

Figure 3 Preoperative anteroposterior radiograph of a Vancouver type-B2 periprosthetic femoral fracture in a 61-year-old man (A) treated with an uncemented femoral revision (B). Fracture was healed and uncemented modular tapered fluted revision stem was well osteointegrated after 1 year of surgery.

Table 3 Early and Late Complications

Complications	Study Group	Control Group
	(21 Hips; 21 Patients)	(16 Hips; 16 Patients)
Early (< 3 months)	17	4
Dislocation	2	–
Periprosthetic infection	–	2
Peroneal nerve palsy	–	1
Pneumonia	3	–
Pressure sores	3	1
Electrolyte imbalance	2	–
Ventricular tachyfibrillation	2	–
Postoperative confusion	2	–
Aspiration	1	–
Cerebrovascular accident	1	–
Urinary tract infection	1	–
Late (> 3 months)	2	1
Dislocation	1	–
Periprosthetic infection	1	1
TOTAL	19	5